Evidence map›Paper›PMID 41047384›Full record

ArticleEnvironmental health : a global access science source2025

A nationwide analysis of heat and workplace injuries in the United States.

Barrak Alahmad, William Kessler, Yazan Alwadi, Joel Schwartz, Gregory R Wagner, David Michaels

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Environmental health : a global access science source, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07617649 (Laboratory Based Identification of Heat Stress Biomarkers and Effective Cooling Interventions), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07617649 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Laboratory Based Identification of Heat Stress Biomarkers and Effective Cooling Interventions

TypeinterventionalSponsorStanford UniversityRan2026 to 2028Enrolled30ConditionsHyperthermiaArmsHand cooling table, Cooling bandana
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Barrak AlahmadEnvironmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA, USA. balahmad@hsph.harvard.edu.
William KesslerEnvironmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Yazan AlwadiEnvironmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Joel SchwartzEnvironmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Gregory R WagnerEnvironmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
David MichaelsEnvironmental and Occupational Health Department, George Washington University Milken Institute School of Public Health, Washington, DC, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExposure to heat leads to physiological and cognitive impairments that increase the risk of workplace injuries. This study estimates the number and proportion of work injuries reported to the United States Occupational Safety and Health Administration (OSHA) that can be attributed to heat exposure. These estimates contribute to the calculation of the benefits of standards, policies, and programs that reduce workplace exposure to extreme heat.

methodsWe analyzed all 2023 injury cases reported to OSHA's Injury Tracking Application by establishments with 100 or more employees, primarily in high-hazard industries. Each injury was geocoded and matched with high-resolution weather data for the specific injury date. Using a case-crossover design, we compared heat index on each injury day (case) with matched non-injury control days for the same worker. Conditional logistic regression was applied separately for summer-only and year-round periods with a non-linear term for heat index to estimate the odds ratios for injury occurrence. We additionally examined heat-injury patterns by industry sectors and in states with/without workplace heat standards.

resultsThe odds of work injury increased non-linearly with a rising heat index: the pooled national estimate showed a clear upward trend starting around 85°F and accelerating above 90°F. Our results were consistent across nearly all industry sectors, including those that are predominantly indoors. Using a heat index of 80°F as reference, odds ratios (OR) of injuries at or above 90°F, 100°F and 110°F were 1.03 (95% confidence intervals [CI]: 1.02, 1.04), 1.10 (1.07, 1.13), and 1.20 (1.13, 1.26), respectively. At a heat index of 110°F or higher, the odds increased by 22% in states without occupational heat rules (OR=1.22; 1.15,1.29) versus 9% in states with rules (OR=1.09; 0.84, 1.41), suggesting a protective effect, although confidence intervals overlapped. Overall, we estimate 1.18% (95% empirical CI: 0.92%, 1.45%) of all injuries were attributable to heat exposure on days exceeding a heat index of 70°F.

conclusionHeat exposure increases the overall risk of work injury, an effect consistent across nearly all major industries.

Indexed as

Hot TemperatureOccupational ExposureOccupational InjuriesAdultFemaleHumansMaleMiddle AgedUnited StatesUnited States Occupational Safety and Health AdministrationWorkplaceClimate changeExtreme heatHeat indexHeat related injuriesHeat ruleHeat standardsOccupational heatOSHA

Identifiers

PMID41047384
PMCPMC12498468

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.